The present invention generally relates to orthodontics and, more particularly, to an orthodontic appliance that exerts a desired force on a patient to change at least one spacing associated with the patient (e.g., palatal expansion).
It is oftentimes necessary to expand the palate as an orthopedic prerequisite for orthodontic treatment. Palatal expansion increases arch length as needed to correct crowding and in the process, establishes a more morphologic arch form for subsequently establishing the aesthetic orthodontic alignment of the teeth. Narrow, constricted arches are often the result of destructive oral habits such as thumb sucking and tongue thrusting. The sequela of such habits not only makes attainment and maintenance of a stable transverse width difficult, such conditions are commonly associated with significant orthodontic mal-alignment of the teeth as well as a non-harmonious occlusion between the arches. For many orthodontic cases, the orthopedic step of palatal expansion must be accomplished before the subsequent steps of orthodontically moving the teeth into alignment and orthopedically moving both arches into a harmonious relationship.
Palatal expansion of the above-noted type is commonly accomplished utilizing a palatal expansion device known as an expansion screw. The method of palatal expansion using expansion screws has become known in the art as xe2x80x9crapid palatal expansionxe2x80x9d (RPE). Conventional palatal expansion devices are at least generally rigid structures that typically include at least one screw mechanism (e.g., a jackscrew). Such conventional palatal expansion devices may be installed into an oral cavity of a patient in a variety of appropriate manners, such as by interconnecting the device to one or more teeth on each side of the palatal suture or a sagittal midline of the arch. Typically, torquing/rotating the screw mechanism of the palatal expansion device to a desired position at least assists in generating expansive force on the patient""s palate. Over time, exertion of this expansive force on the patient""s palate due to utilizing such a palatal expansion device ideally results in a widening of the patient""s palate.
The above-described type of palatal expansion device is most commonly installed on the upper dental arch of a patient by an appropriate professional (e.g., an orthodontist). Subsequent to installation of the device, regular and/or systematic adjustment of the device is generally desired to promote the potential for appropriate change in spacing of the patient""s dental arch. This adjustment is typically attempted via an individual (e.g., the patient, a relative or friend of the patient or otherwise) reaching into and/or inserting a tool into the patient""s oral cavity and thereafter rotating/torquing the above-mentioned screw mechanism of the palatal expansion device. For example, an orthodontist may prescribe that the patient have the patient""s mother or father adjust the palatal expansion device every evening via rotating the screw mechanism a defined amount. However, adjustment of these palatal expansion devices has left much to be desired in that the individual generally responsible for making these adjustments typically does not have in education in orthodontics or orthodontic devices, and thus, typically has not been equipped with a way of providing that such adjustments exhibit the prescribed amount of rotational adjustment on a day-to-day basis. Accordingly, this may result in inefficient treatment due to these regular adjustments falling short of the prescribed amount of screw rotation. Alternatively, this may result in an increased potential for unnecessary pain and/or injury to the patient as a result of one or more of the adjustments exceeding the prescribed amount of rotation.
In addition, rather significant treatment forces may be exerted on the patient by utilizing these types of palatal expansion devices. As mentioned above, the expansive force of a particular expansion device is typically altered by rotating/torquing the associated screw mechanism (e.g., jackscrew). This expansive force is at least generally physiologically/anatomically resisted by reciprocal (i.e., contractile or compression) forces due to the patient""s biological makeup, which promote a xe2x80x9cstatus quoxe2x80x9d contour/shape of the palate. In other words, these reciprocal forces tend to oppose augmentation of the arch of the oral cavity. Moreover, these reciprocal forces may potentially exact enough force on the palatal expansion device that the screw mechanism may undesirably back out or unwind with regard to the rest of the palatal expansion device. This is commonly referred to as xe2x80x9cbackoff.xe2x80x9d xe2x80x9cBack-offxe2x80x9d also occurs due to the reciprocal, resistive physiological forces, in combination with slight flexing of an appliance structure during mastication, speaking and normal tongue movement. Such movements or slight flexing of the appliance, during use, all contribute to xe2x80x9cwalkingxe2x80x9d of the screw in the direction of least resistance, which is xe2x80x9cback-off.xe2x80x9d In any case, the design/configuration of the screw mechanisms of these palatal expansion devices typically enables these devices to xe2x80x9cloosenxe2x80x9d or contract and provide less than the desired amount of expansive force on the patient""s palate.
Accordingly, it would be desirable to provide a palatal expansion device that increases the potential for adjusting the palatal expansion device in a substantially controlled/defined manner. Similarly, it would be desirable to provide a palatal expansion device that increases the potential for promoting/maintaining desired levels of expansive forces upon installation into the oral cavity of a patient.
Accordingly, the present invention is generally embodied by an orthodontic mechanical force module that may be designed to selectively enable only unidirectional adjustment (e.g., rotation) of an associated screw mechanism (or xe2x80x9cspindlexe2x80x9d) to increase the treatment forces, and thereby decreasing the potential of an undesired reduction of these treatment forces over time. Moreover, the design of such an orthodontic mechanical force module of the present invention may desirably promote one or both of achieving and maintaining a desired positioning of the screw mechanism (or xe2x80x9cspindlexe2x80x9d) relative to the remainder of the orthodontic mechanical force module by enabling regular, predetermined incremental advances for the screw mechanism. Although the present invention is particularly suited for use in palatal expansion applications, the present invention may be applicable to any type of orthodontic treatment where a change in a spacing is a desirable objective (e.g., for distalizing molars on one side of a given dental arch), and regardless of whether this change in spacing is an increase or a decrease.
Adjustment of the treatment forces associated with one or more aspects of the present invention may occur on a relatively frequent basis due to the significant biological response elicited in typically young and growing adolescent patients. In many cases, daily adjustment of the treatment forces associated with one or more aspects of the present invention will be prescribed by an orthodontist. As such, the benefits associated with the one or more aspects of the present invention in reducing the potential for an undesired reduction of treatment forces will be similarly utilized on an equally frequent basis.
A first aspect of the present invention is embodied by an orthodontic mechanical force module that includes first and second housings. A rotatable spindle is rotatably interconnected with both the first and second housings. The spindle is further threadably interconnected with the first housing. That is, both the first housing and at least a portion of the spindle are threaded. Rotation of the spindle thereby causes the first housing to move along the spindle (e.g., along its length dimension) while the spindle rotates relative to both the first and second housings. A ratchet is associated with the spindle and is of the type that when engaged or active, allows for rotation of the spindle in one direction, but not in the opposite direction.
Various refinements exist of the features noted in relation to the subject first aspect of the present invention. Further features may also be incorporated in the subject first aspect of the present invention as well. These refinements and additional features may exist individually or in any combination. The first and second housings may be interconnected with a patient in any appropriate manner. For instance, the first and second housing may each be directly attached to the buccal of a tooth on one side of a patient""s dental arch for a molar distalization application or otherwise. In a palatal expansion application, the first housing may be interconnected in any appropriate manner with one side of the patient""s dental arch, while the second housing may be interconnected in any appropriate manner with the opposite side of the patient""s dental arch. For example, one portion of a separate suitable wire may be fixed or anchored (e.g., soldered; brazed; welded) to each of the first and second housings, while another portion of this same wire may be fixed or anchored (e.g., soldered; brazed; welded) to a band disposed on the patient""s tooth and/or structure interconnected therewith (e.g., a lingual wire segment that is fixed to the band and that engages multiple teeth on lingual side thereof). Multiple wires could be attached to each of the first and second housings as well.
The second housing associated with the orthodontic mechanical force module of the first aspect may remain at the same position along the length of the spindle during rotation of the spindle. That is, the second housing and the spindle would not be threadably interconnected in this case. Alternatively, the second housing may also be threadably interconnected with the spindle (i.e., both the second housing and an interfacing portion of the spindle each being threaded), such that rotation of the spindle also causes the second housing to move along the spindle. In this latter embodiment, the first and second housings simultaneously move in opposite directions along the spindle by rotating the spindle. This movement may be affected by having right hand threads for the engagement between the first housing and the spindle, and left hand threads for the engagement between the second housing and the spindle. In any case, the first and second housings may be interconnected with the patient in such a manner that increasing the spacing between the first and second housings by movement of at least one of the first and second housings along the spindle increases a magnitude of the treatment forces that are exerted on the patient. Alternatively, the first and second housings may be interconnected with the patient in such a manner that decreasing the spacing between the first and second housings by movement of at least one of the first and second housings along the spindle increases of the magnitude of the treatment forces that are exerted on the patient. Changing the spacing between the first and second housings ultimately changes the spacing between at least those locations on the patient where the first and second housings are interconnected or anchored. The orthodontic mechanical force module of the first aspect may include at least one guide pin that is slidably interconnected with both the first and second housings. Typically this will be for a palatal expansion application, although it may be appropriate for other applications as well. In this case, the first and second housings each may include a spindle aperture and a first guide pin aperture into which the spindle and a first guide pin extend. Multiple guide pin apertures could be included on both the first and second housings if multiple guide pins were used. Any such apertures in the first and second housings may be oriented so as to dispose all guide pins (including the first guide pin) and spindle in at least substantially parallel relation.
The ratchet associated with the first aspect of the present invention may include a ratchet wheel and a pawl assembly. The ratchet wheel may be included on (e.g., mounted on) or be part of the spindle. For instance, the spindle and ratchet wheel may simultaneously rotate about a common axis to change the spacing between the first and second housings as at least one of the first and second housings moves along the spindle during/from rotation of the spindle. The pawl assembly may include a pawl of the type that when engaged with the ratchet wheel, the ratchet wheel is only able to rotate in a single direction. Rotation of the ratchet wheel in the opposite direction may be realized by moving the pawl sufficiently out of engagement with the ratchet wheel. In this respect, the pawl may be characterized as being at least generally movable between first and second positions, with the ratchet wheel being rotatable only in a first direction when the pawl is in its first position, and with the ratchet wheel being rotatable in at least a second, opposite direction when the pawl is in its second position (as well as possibly in the first direction if desired/required when in this second position). The above-noted pawl assembly that may be used by the orthodontic mechanical force module of the first aspect may be biased (e.g., resiliently) into engagement with the ratchet wheel, may be of any appropriate configuration, or both. In one embodiment, the pawl is in the form of a cantilever or the like. Preferably the pawl is formed from a tempered metal to provide a desired bias toward the ratchet wheel. In one embodiment, such a pawl is within a range of xc2xc hard to full hard relative to the hardness range that a spring temper alloy material is able to be hardened through induced work hardening. In another embodiment, such a pawl is within a range of about 160 KSI UTS to about 300 KSI UTS.
Integration of the above-described pawl assembly that may be used by the orthodontic mechanical force module of the first aspect may include providing first and second concave recesses (that is, a cavity formed on an exterior surface) on the pawl assembly such that a first guide pin may be at least partially seated in the first concave recess, and such that the spindle may be at least partially seated in the second concave recess. These first and second concave recesses may be disposed on opposite sides of the pawl assembly and may project in at least generally opposite directions such that at least a portion of the pawl assembly will be interposed or sandwiched between the first guide pin and the spindle. This configuration alleviates the need to fix or anchor the pawl assembly to one or both of the first guide pin and spindle.
The spindle (or any structure rotatable therewith) associated with the first aspect may include at least one, and more preferably a plurality, of through holes. Multiple through holes would preferably be disposed at the same location along the length of the spindle and so as to intersect at a center axis along which the spindle may extend. In any case, each through hole provides two apertures on an exterior surface of the spindle that could be engaged by an appropriate tool to rotate the spindle in a direction that would increase the treatment forces being exerted on the patient by changing the spacing between the first and second housings along the spindle in a predetermined manner. Preferably these apertures defined by the through hole(s) are radially spaced in at least substantially equal fashion about the circumference of the spindle and further so that at least one aperture would be available for engagement by an appropriate tool, regardless of the rotational position of the ratchet when rotation in one direction is being restrained. In one embodiment, two through holes are utilized, and these through holes are disposed perpendicular to each other, intersect at a centerline of the spindle, and are clocked relative to notches or the like on the ratchet wheel for a number of purposes. First, an end of one of these two through holes will always be disposed in the same position for engagement by an appropriate tool, regardless of the position of the ratchet when its rotational motion is being restrained in one direction. Second, an appropriate tool may be inserted though this end of the particular through hole to rotate the spindle a full 90 degrees without encountering any obstruction (e.g., any structure of the force module; any portion of the anatomy of the patient (e.g., teeth, gums, palate)). Third, such a tool may be removed from the end of the particular through hole after the noted 90 degree rotation without encountering any obstruction (e.g., any structure of the force module; any portion of the anatomy of the patient (e.g., teeth, gums, palate)) as well.
The above-noted through holes that may be used by the first aspect also may be used to deactivate the ratchet. The above-noted pawl may be disposed over at least part of one end of a through hole (e.g., the pawl may be aligned with the entirety of the through hole; the pawl may be aligned with only part of the through hole, and thereby at least partially occluding a through hole)) and in spaced relation thereto when the pawl is engaged with the ratchet wheel in a manner so as to preclude rotation of the ratchet wheel in one direction, or when the pawl is seated against the ratchet wheel in a manner so as to preclude rotation of the spindle in a direction that would reduce the magnitude of the treatment forces being exerted on the patient. This through hole may then be used to move the pawl away from the ratchet wheel to allow for bidirectional rotation of the spindle or at least to rotate in a direction so as to deactivate the ratchet (e.g., to thereby allow rotation of the spindle in a direction that would reduce the magnitude of the treatment forces being exerted on the patient). That is, an appropriate tool may be disposed into at least an end of a through hole that is opposite that end of the through hole over which the pawl is at least partially disposed in spaced relation thereto, and the tool may then be extended through the through hole and then therebeyond to engage the pawl and unseat the pawl from the ratchet wheel.
The ratchet wheel of the ratchet that may be utilized by the first aspect may be defined by a pair of bosses or flanges that are spaced along the length of the spindle, that have a larger diameter than adjacent portions of the spindle, and that include a plurality of notches or other appropriate apertures, for instance on a peripheral surface of these bosses. The pawl of the ratchet may simultaneously engage a notch on each of these bosses, or stated another way, the notches on one of the bosses may be disposed at the same radial position as the notches on the other boss. Preferably, the notches on each of the bosses are at least substantially equally spaced about the circumference of the peripheral surface of the bosses. One or more of the above-described through holes may be located between the noted pair of bosses and for one or more of the above-described purposes. Other ratchet wheel configurations may be appropriate, although the configuration described herein provides a number of advantages.
There is a preferred configuration for that peripheral surface(s) of the ratchet wheel on which the pawl xe2x80x9cridesxe2x80x9d in the case of the first aspect when providing the ratcheting function. Although this feature will be described in relation to the above-described pair of bosses, it is applicable to other ratchet wheel configurations as well. Generally, the plurality of radially spaced notches on the peripheral surface of each boss may be separated by an arcuate surface. Each such arcuate surface may be characterized as a transition section. In one embodiment, each transition section is defined by a common radius that is located along the centerline of the spindle. The pawl will then ride on a transition section on each boss when proceeding from one notch to the next during rotation of the spindle in a direction that provides for an increase in treatment forces. The notches on each boss may be configured such that the pawl will momentarily lose contact with the bosses when xe2x80x9cdroppingxe2x80x9d into the next notch on each boss. This will preferably make a discernible sound that may be used when making an adjustment of the force module (e.g., to signify a predetermined amount of rotation of the spindle has been achieved). Although various notch configurations may allow the pawl to momentarily lose contact to make such a discernible sound, in one embodiment each notch on each boss is defined by a pair of at least generally flat surfaces that are disposed at least generally perpendicular to each other. Moreover, the flat surface of a given notch that follows a transition section in the direction of rotation of the spindle when increasing treatment forces may extend at least generally toward the centerline of the spindle. This provides a xe2x80x9cdrop offxe2x80x9d of sorts between this transition section and the other flat surface of the corresponding notch onto which the pawl xe2x80x9cdropsxe2x80x9d to again make a discernible sound.
The above-noted bosses that may be utilized by the first aspect may provide other functions than as a ratchet wheel. The bosses may be used to limit the translation of a first guide pin of the above-described type along its length dimension. In this regard, the first guide pin may include a collar that is retained between the pair of bosses on the spindle. This collar may have a larger diameter than adjacent portions of the first guide pin, those portions of the first guide pin that are slidably engaged with the first and second housings, or both. Moreover, the bosses may function to locate the pawl assembly relative to the spindle in the length dimension. For instance, the pawl assembly may include a pair of legs that are spaced so that the noted pair of bosses may be located therebetween. A pair of oppositely disposed surfaces of each of these legs may then include the above-noted first and second concave recesses.
A second aspect of the present invention is embodied by an orthodontic mechanical force module that includes first and second housings. Both the first housing and second housings are rotatably interconnected with a spindle. That is, the spindle is able to rotate relative to both the first and second housings. At least one of the first and second housings is also threadably interconnected with the spindle so as to move along the spindle during/from rotation of the spindle. That is, at least one of the first and second housings is threaded, along with at least a segment of the spindle. Movement of at least one of the first and second housings along the spindle changes the relative position between the first and second housings along the spindle, and thereby the treatment forces being exerted on the patient. A plurality of detent apertures are associated with the spindle and are radially spaced about an axis (e.g., a rotational axis of the spindle). A detent engages one of these detent apertures as the spindle rotation causes any one detent aperture to move into alignment with the detent. There also is a plurality of adjustment or activation apertures associated with the spindle that are also radially spaced about the same axis as the detent apertures and into which a tool may be inserted to rotate the spindle. However, these adjustment apertures are spaced along the length dimension of the spindle from the detent apertures and are thereby separate structures from the detent apertures. Stated another way, the adjustment apertures and the detent apertures are not disposed along a common line that extends about the circumference of the spindle.
Various refinements exist of the features noted in relation to the subject second aspect of the present invention. Further features may also be incorporated in the subject second aspect of the present invention as well. These refinements and additional features may exist individually or in any combination. The orthodontic mechanical force module of the second aspect may include a ratchet wheel that is mounted on or is part of, and in any case rotatable with, the spindle. This orthodontic mechanical force module may further include a pawl that is at least engageable with the ratchet wheel to prevent rotation of the same in one direction when appropriately engaged therewith, but which will allow rotation of the ratchet wheel in the opposite direction even when the pawl is engaging the ratchet wheel. The plurality of detent apertures may be disposed on the ratchet wheel and the pawl may correspond with a detent.
The ratchet wheel that may be associated with the orthodontic mechanical force module of the second aspect may be defined by a pair of bosses that are spaced along the spindle and that include a plurality of notches on a peripheral surface thereof to define the detent apertures. The pawl may simultaneously engage a notch on each of these bosses. Moreover, the noted adjustment apertures may be disposed between this pair of bosses. In the case where the adjustment apertures are in the form of through holes, an appropriate tool may be inserted through one end of a particular through hole and beyond its opposite end to sufficiently unseat the pawl from the ratchet wheel to allow bi-directional rotation of the ratchet wheel. When engaged with the ratchet wheel to allow only one directional rotation of the ratchet wheel, the pawl may be disposed in spaced relation to, but at least partially aligned with, at least one of the through holes to facilitate this type of unseating of the pawl from the ratchet wheel.
The pawl that may be utilized by the orthodontic mechanical force module of the second aspect may be biased into engagement with the ratchet wheel. The interface between the pawl and the ratchet wheel may be such that the pawl at least substantially directly and mechanically opposes rotation of the ratchet wheel in one direction when engaged with at least one of the notches of the ratchet wheel. In one embodiment and for purposes of providing this type of mechanical opposition, the pawl is disposed within 20 degrees of a tangent to a peripheral surface of the ratchet wheel at a location that is between adjacent pairs of notches on the ratchet wheel. Stated another way and again for purposes of providing the above-noted type of mechanical opposition, the pawl may be disposed relative to the ratchet wheel so as to be disposed at an angle from about 70 degrees to about 110 degrees relative to an imaginary radius line extending outwardly from a center of the spindle to the point of engagement between the pawl and the ratchet wheel to preclude rotation in one direction (but not in the opposite direction).
The plurality of radially spaced adjustment apertures utilized by the orthodontic mechanical force module of the second aspect may be in the form of a pair of through holes that extend entirely through the spindle, that intersect at a centerline of the spindle, and that are disposed in perpendicular relation to each other. This would then provide four adjustment apertures that were each separated by a radial spacing of 90 degrees. Preferably, these four adjustment apertures are clocked relative to the plurality of detent apertures such that: 1) one adjustment aperture will be disposed at the same position for engagement by an appropriate adjusting tool, regardless of which detent aperture is being engaged by the detent to restrict rotation of the spindle in one direction; and 2) this same adjustment aperture will be disposed so as to allow for a full 90 degrees of rotation of the spindle with an appropriate tool and for subsequent removal of the tool after the rotation, all without encountering an obstruction between the adjusting tool and any portion of the force module, and as such, a full 90 degrees of rotation can be accomplished without having to remove and re-insert the activation tool.
The various features discussed above in relation to the first aspect of the present invention may be utilized by this second aspect of the present invention as well. In addition, the various features discussed in relation to this second aspect may be utilized by the first aspect as well.
A third aspect of the present invention is embodied by an orthodontic mechanical force module that includes first and second housings. A rotatable spindle is rotatably interconnected with both the first and second housings. At least one of the first and second housings is also threadably interconnected with the spindle as well. Rotation of the spindle thereby causes at least one of the first and second housings to move along the spindle while the spindle rotates relative to both the first and second housings. At least one through hole is provided on the spindle (which includes any structure that rotates therewith). The spindle includes a ratchet wheel that interacts with a pawl. At least when the pawl is engaged with the ratchet wheel so as to preclude rotation of the ratchet wheel in one direction, the pawl is disposed in at least partially overlying and spaced relation to the through hole. That is, at least a portion of the pawl is disposed vertically beyond that portion of the exterior surface of the spindle on which an adjacent end of the noted through hole is disposed (the xe2x80x9cadjacent endxe2x80x9d being that end of the through hole that is closest to the overlying pawl). The pawl may then be characterized as at least partially occluding this adjacent end of the noted through hole. Such a through hole may then be used for one or more of the above-noted purposes discussed in relation to the first aspect. Moreover, the various features discussed above in relation to one or both of the first and second aspects may be used individually or in any combination in relation to this third aspect of the present invention as well, and vice versa.
A fourth aspect of the present invention is embodied by a method of operating an orthodontic mechanical force module installed on a patient. This method includes increasing a magnitude of a treatment force being exerted on the patient by the orthodontic mechanical force module using a first tool. This method also includes decreasing the magnitude of the treatment force being exerted on the patient by the orthodontic mechanical force module using a second tool that is structurally different from the first tool in at least one respect.
Various refinements exist of the features noted in relation to the subject fourth aspect of the present invention. Further features may also be incorporated in the subject fourth aspect of the present invention as well. These refinements and additional features may exist individually or in any combination. The first tool may be configured such that it would not be able to be used to reduce the magnitude of the treatment forces being exerted on the patient. Consider a protocol where a caregiver is provided with the first tool and not the second tool, and where the treating practitioner retains the second tool. This allows the caregiver to at least assist in the execution of a treatment plan by increasing the treatment forces being exerted on the patient, typically on some repeating basis (e.g. nightly). However, since the caregiver does not have the second tool, the caregiver would not be able to reduce the magnitude of the treatment forces. Instead, any such reduction in the treatment forces would require an office visit of sorts, where the practitioner would use the retained second tool to reduce the magnitude of the treatment forces being exerted on the patient. In the case of the orthodontic mechanical force module of the first aspect having at least one through hole on the spindle for purposes of moving the pawl away from the ratchet wheel, the first tool of this fourth aspect may include a stop that prevents the first tool from being inserted far enough within a given through hole to move the pawl out of engagement with the ratchet wheel. However, the second tool would be insertable sufficiently through a given through hole so as to be able to engage the pawl and move the pawl out of engagement with the ratchet wheel.
Increasing the magnitude of the treatment forces in the case of the fourth aspect may include changing a spacing between a pair of housings of the orthodontic mechanical force module along a spindle of the orthodontic mechanical force module in one manner, while decreasing the magnitude of the treatment forces may include changing the spacing between this pair of housings along the spindle in an opposite manner. For instance, if the treatment forces are increased by increasing the spacing between the pair of housings, the treatment forces may be reduced by reducing the spacing between the pair of housings. Similarly, if the treatment forces are increased by decreasing the spacing between the pair of housings, the treatment forces may be reduced by increasing the spacing between the pair of housings. Changing the spacing between the noted pair of housings along the spindle may include moving one or both of these housings along the spindle, for instance in the manner discussed above in relation to the first aspect.
A fifth aspect of the present invention is embodied by a method of operating an orthodontic mechanical force module. This method includes changing a spacing between first and second housings of the module along a spindle of the module in one manner using a first tool to rotate the spindle in a first direction, and changing a spacing between the first and second housings along the spindle in an opposite manner using a second tool to rotate the spindle in a second direction that is opposite the first direction. The second tool is structurally different from the first tool in at least one respect.
Various refinements exist of the features noted in relation to the subject fifth aspect of the present invention. Further features may also be incorporated in the subject fifth aspect of the present invention as well. These refinements and additional features may exist individually or in any combination. The spacing between the first and second housings may dictate the magnitude of the treatment forces being exerted on the patient. Increasing the magnitude of the treatment forces in the case of the fifth aspect may include moving at least the first housing along a spindle in one manner, while decreasing the magnitude of the treatment forces may include moving at least the first housing along the spindle in an opposite manner. For instance, if the treatment forces are increased by increasing the spacing between the first and second housings, the treatment forces may be reduced by reducing the spacing between the first and second housings. Similarly, if the treatment forces are increased by decreasing the spacing between the first and second housings, the treatment forces may be reduced by increasing the spacing between the first and second housings.
The first tool associated with the subject fifth aspect may be configured such that it would only be able to rotate the spindle in one direction, but not in the opposite direction. Consider a protocol where a caregiver is provided with the first tool and not the second tool, and where the treating practitioner retains the second tool. This allows the caregiver to at least assist in the execution of a treatment plan by increasing the treatment forces being exerted on the patient, typically on some repeating basis (e.g. nightly). However, since the caregiver does not have the second tool, the caregiver would not be able to reduce the magnitude of the treatment forces. Instead, any such reduction in the treatment forces would require an office visit of sorts, where the practitioner would use the retained second tool to reduce the magnitude of the treatment forces being exerted on the patient. In the case of the orthodontic mechanical force module of the first aspect having at least one through hole on the spindle for purposes of moving the pawl away from the ratchet wheel, the first tool of this fifth aspect may include a stop that prevents the first tool from being inserted far enough within a given through hole to move the pawl out of engagement with the ratchet wheel. However, the second tool would be insertable sufficiently through a given through hole so as to be able to engage the pawl and move the pawl out of engagement with the ratchet wheel.
A sixth aspect on the present invention is embodied by a method for operating an orthodontic mechanical force module that includes a spindle and a first housing. The spindle is rotated in a first direction to move the first housing along the spindle. The orthodontic mechanical force module may be disposed in a first mode to provide a greater resistance to a rotation of the spindle in a second direction than in the noted first direction. This resistance to a rotation of the spindle in the second direction may be provided by a ratchet of the type discussed above in relation to the first aspect, in which case the magnitude of resistance to rotation in the second direction may be one that precludes rotation of the spindle in the second direction absent a failure of the ratchet. The module may also be disposed in a second mode to provide at least substantially the same magnitude of resistance (including no substantial resistance) to rotation of the spindle in both the first and second directions.
A seventh aspect of the present invention is embodied by a method of assembling or disassembling an orthodontic mechanical force module. A spindle and pawl assembly of the orthodontic mechanical force module are disposed in a predetermined positional relationship relative to each other. This pawl assembly includes a pawl and a ratchet wheel. The pawl is forced out of engagement with the ratchet wheel to a degree where the ratchet wheel may rotate in either direction. First and second housings of the module are positioned on first and second ends of the spindle, respectively, while the pawl is sufficiently disengaged from the ratchet wheel to allow rotation in either direction. The movement of at least one of the first and second housings relative to the spindle is thereafter affected by rotation of the spindle relative to the first and second housings. One or more fixtures may be utilized by this seventh aspect to facilitate the execution of one or more of the steps of this seventh aspect. One or more of such fixtures could be adapted or configured to accommodate the entire structure of the force module, for instance any guide pin(s) utilized by the force module.
An eighth aspect of the present invention is embodied by a method for executing an orthodontic treatment. An orthodontic mechanical force module is anchored to a patent at two different locations within the patient""s mouth (e.g. to two different teeth; to two different groups of teeth). The module includes a spindle and first and second housings that are both mounted on and movably interconnected with the spindle. Rotation of the spindle moves at least the first housing along the spindle to change the spacing between the first and second housings, to in turn change the treatment force being exerted on the patient. Instructions are provided regarding a treatment plan to be executed for the patient, where the treatment plan includes undertaking a plurality of spaced-in-time activations of the module (e.g., done by a parent). In the case where treatment forces are increased by increasing the spacing between the first and second housings, each activation of the module in relation to the eighth aspect entails rotating the spindle in a first direction using a first tool to increase the spacing between the first and second housings. An assessment of the patient is done (e.g., by an orthodontist) at some point in time after the instructions were provided as to the treatment plan to be followed. This assessment may be done knowing that the spindle has not been rotated in a second direction using the first tool, at any time after the instructions were provided, to achieve a spacing between the pair of housings that is less than a spacing between the pair of housings from an immediately preceding (in time) activation. Rotation of the spindle in the second direction in this case would decrease the spacing between the pair of housings, and thereby the treatment forces being exerted on the patient. Stated another way, the first tool may not be used to reduce the treatment forces from that which was provided from the most recent activation of the module.
In the case where treatment forces are increased by decreasing the spacing between the first and second housings, each activation of the module in relation to the eighth aspect entails rotating the spindle in a first direction using a first tool to decrease the spacing between the first and second housings. An assessment of the patient is done (e.g., by an orthodontist) at some point in time after the instructions were provided as to the treatment plan to be followed. This assessment also may be done knowing that the spindle has not been rotated in a second direction using the first tool, at any time after the instructions were provided, to achieve a spacing between the pair of housings that is more than a spacing between the pair of housings from an immediately preceding (in time) activation. Rotation of the spindle in the second direction in this case would increase the spacing between the pair of housings, and thereby decrease the treatment forces being exerted on the patient. Stated another way, the first tool may not be used to reduce the treatment forces from that which was provided from the most recent activation of the module.
A ninth aspect of the present invention is embodied by a method for executing an orthodontic treatment. An orthodontic mechanical force module is anchored to a patent at two different locations within the patient""s mouth (e.g. to two different teeth; to two different groups of teeth). The module includes a spindle and first and second housings that are both mounted on and movably interconnected with the spindle. Rotation of the spindle moves at least the first housing along the spindle to change the spacing between the first and second housings, to in turn change the treatment force being exerted on the patient. A certain amount of rotation of the spindle at a given time may be characterized as an activation. At least one activation of the module of this nature is undertaken. A tactile indication is provided of an attempt to rotate the spindle in the second direction or at least of an attempt to rotate the spindle in a second direction more than a predetermined amount (e.g., to rotate the spindle through a distance corresponding with a spacing between notches of a ratchet wheel associated with the spindle). The second direction is opposite the first direction, and would thereby tend to move the first and second housings relative to each other in a direction that would tend to reduce the magnitude of the treatment forces being exerted on the patient.